ATI Pediatrics Proctored Exam Updated 2026 | 250+ Practice
Questions & Answers | Comprehensive Study Guide, Exam
Prep Test Bank, Growth & Development, Pediatric Assessment,
Family-Centered Care, Neonatal Nursing, Pediatric
Pharmacology, Childhood Disorders, Immunizations,
Medication Administration, Clinical Judgment, Detailed
Rationales, ATI RN & NCLEX-RN Success
Question 1: A nurse is assessing a 6-month-old infant during a well-child visit.
Which of the following findings should the nurse report to the provider?
A. The infant's anterior fontanel is open and feels flat.
B. The infant can roll from back to abdomen.
C. The infant's birth weight has tripled.
D. The infant exhibits a positive Moro reflex.
CORRECT ANSWER: D. The infant exhibits a positive Moro reflex.
Rationale:The Moro reflex is a primitive reflex that typically disappears by 3 to 4
months of age. Its persistence at 6 months is a neurological concern and should be
reported. The anterior fontanel normally closes between 12 and 18 months; rolling over
is expected by 6 months; and birth weight usually doubles by 4-6 months, not triples
(tripling occurs around 12 months).
Question 2: A nurse is planning care for a child with sickle cell anemia who is
in a vaso-occlusive crisis. Which of the following interventions should the
nurse prioritize?
A. Restrict oral fluid intake to prevent fluid overload.
B. Apply cold compresses to painful joints.
C. Administer meperidine for pain management.
D. Maintain adequate hydration with IV fluids.
CORRECT ANSWER: D. Maintain adequate hydration with IV fluids.
Rationale:Hydration is crucial in a vaso-occlusive crisis to decrease blood viscosity and
improve perfusion. Fluid restriction is contraindicated. Warm compresses, not cold, are
used to vasodilate and reduce pain. Meperidine is avoided due to the risk of seizures;
morphine or other non-opioid analgesics are preferred.
Question 3: A nurse is assessing a toddler with suspected lead poisoning.
Which of the following findings is a late manifestation of lead toxicity?
A. Irritability
B. Anorexia
C. Encephalopathy
D. Intermittent vomiting
CORRECT ANSWER: C. Encephalopathy
,Rationale:Encephalopathy (seizures, coma, cerebral edema) is a severe, late
manifestation of lead poisoning. Irritability, anorexia, and intermittent vomiting are early
or mild signs of lead toxicity.
Question 4: A nurse is providing education to a parent of a child with a new
diagnosis of type 1 diabetes mellitus. The parent asks about symptoms of
hypoglycemia. Which of the following is an early sign the nurse should
include?
A. Fruity breath odor
B. Kussmaul respirations
C. Shakiness and pallor
D. Polyuria and polydipsia
CORRECT ANSWER: C. Shakiness and pallor
Rationale:Shakiness, pallor, diaphoresis, and tachycardia are early signs of
hypoglycemia due to the release of epinephrine. Fruity breath, Kussmaul respirations,
polyuria, and polydipsia are signs of hyperglycemia and diabetic ketoacidosis.
Question 5: A nurse is preparing to administer a measles, mumps, and rubella
(MMR) vaccine to a 12-month-old. Which of the following is a contraindication
for receiving this vaccine?
A. A history of a mild local reaction to a previous diphtheria-tetanus-pertussis (DTaP)
vaccine.
B. A temperature of 37.5°C (99.5°F).
C. A current upper respiratory infection with a runny nose.
D. A severe allergy to neomycin.
CORRECT ANSWER: D. A severe allergy to neomycin.
Rationale:The MMR vaccine contains neomycin and gelatin. A severe allergy to
neomycin is a true contraindication. Mild illness without fever, mild local reactions to
other vaccines, and afebrile URI are not contraindications.
Question 6: A nurse is caring for a 4-year-old child who is postoperative
following a tonsillectomy. The child's parent asks for a drink of water. Which
of the following responses should the nurse give?
A. "It is fine to give your child a small sip of water."
B. "I will give your child some orange juice instead."
C. "Let me give your child some ice chips to chew."
D. "Your child should not have anything to drink yet."
CORRECT ANSWER: A. "It is fine to give your child a small sip of water."
Rationale:After a tonsillectomy, clear, cool liquids (e.g., water, apple juice) are
encouraged early to keep the throat moist and promote healing, provided the child is
,fully awake and has a gag reflex. Red liquids (like orange juice) should be avoided to
prevent masking of bleeding. Chewing ice chips can cause trauma to the surgical site.
Question 7: A nurse is assessing an 8-year-old child with cystic fibrosis. Which
of the following findings is most indicative of a pulmonary exacerbation?
A. Increased appetite
B. Decreased respiratory rate
C. Thick, tenacious sputum production
D. Weight gain
CORRECT ANSWER: C. Thick, tenacious sputum production
Rationale:Increased sputum production, particularly thick and tenacious mucus,
indicates a pulmonary exacerbation in cystic fibrosis. Appetite usually decreases,
respiratory rate increases, and weight loss is common during exacerbations due to
increased metabolic demands.
Question 8: A nurse is teaching a parent about the administration of ferrous
sulfate drops for an infant with iron-deficiency anemia. Which instruction
should the nurse include?
A. Administer the drops with milk to improve absorption.
B. Administer the drops with a dropper directly to the back of the throat.
C. Administer the drops with orange juice to enhance absorption.
D. Administer the drops with an antacid to prevent stomach upset.
CORRECT ANSWER: C. Administer the drops with orange juice to enhance
absorption.
Rationale:Vitamin C (found in orange juice) enhances the absorption of iron. Iron
should not be given with milk or antacids as they decrease absorption. Droppers should
be placed at the side of the mouth, not the back of the throat, to prevent aspiration.
Question 9: A nurse is caring for a child who has just had a seizure. Which of
the following actions should the nurse take first?
A. Place the child in a supine position.
B. Administer oxygen via nasal cannula.
C. Check the child's blood glucose level.
D. Assess the child's airway patency.
CORRECT ANSWER: D. Assess the child's airway patency.
Rationale:The immediate priority after a seizure is to assess and maintain airway
patency. The child should be placed in a side-lying position, not supine, to prevent
aspiration. Oxygen and glucose checks are important but secondary to airway
management.
, Question 10: A nurse is assessing a newborn's gestational age using the Ballard
score. Which of the following physical characteristics indicates a mature
newborn?
A. Smooth, shiny, and transparent skin.
B. Absence of sole creases.
C. Pinna of the ear that is soft and flat.
D. Nipples with distinct areola and breast tissue.
CORRECT ANSWER: D. Nipples with distinct areola and breast tissue.
Rationale:Distinct areola and breast tissue are signs of physical maturity in a full-term
newborn. Smooth, shiny skin and absent sole creases indicate prematurity. A soft, flat
pinna is also a sign of prematurity.
Question 11: A nurse is planning to administer the rotavirus vaccine to a 2-
month-old infant. Which of the following is a contraindication for this vaccine?
A. History of intussusception.
B. Mild diarrhea.
C. Exposure to a sibling with roseola.
D. Current antibiotic therapy.
CORRECT ANSWER: A. History of intussusception.
Rationale:Rotavirus vaccine is contraindicated in infants with a history of
intussusception, as there is a small increased risk of recurrence. Mild illness, antibiotic
use, and exposure to roseola are not contraindications.
Question 12: A nurse is assessing a 10-year-old child with acute
glomerulonephritis. Which of the following findings should the nurse expect?
A. Jaundice
B. Periorbital edema
C. Polyuria
D. Hypotension
CORRECT ANSWER: B. Periorbital edema
Rationale:Periorbital edema is a hallmark sign of acute glomerulonephritis due to fluid
retention. Jaundice is associated with liver issues. Oliguria (decreased urine output) and
hypertension are common; polyuria and hypotension are not typical findings.
Question 13: A nurse is caring for a child with a new diagnosis of celiac
disease. The parent asks the nurse which grains are safe for the child to eat.
Which of the following is an appropriate response?
A. Wheat
B. Rye
C. Barley
D. Rice
Questions & Answers | Comprehensive Study Guide, Exam
Prep Test Bank, Growth & Development, Pediatric Assessment,
Family-Centered Care, Neonatal Nursing, Pediatric
Pharmacology, Childhood Disorders, Immunizations,
Medication Administration, Clinical Judgment, Detailed
Rationales, ATI RN & NCLEX-RN Success
Question 1: A nurse is assessing a 6-month-old infant during a well-child visit.
Which of the following findings should the nurse report to the provider?
A. The infant's anterior fontanel is open and feels flat.
B. The infant can roll from back to abdomen.
C. The infant's birth weight has tripled.
D. The infant exhibits a positive Moro reflex.
CORRECT ANSWER: D. The infant exhibits a positive Moro reflex.
Rationale:The Moro reflex is a primitive reflex that typically disappears by 3 to 4
months of age. Its persistence at 6 months is a neurological concern and should be
reported. The anterior fontanel normally closes between 12 and 18 months; rolling over
is expected by 6 months; and birth weight usually doubles by 4-6 months, not triples
(tripling occurs around 12 months).
Question 2: A nurse is planning care for a child with sickle cell anemia who is
in a vaso-occlusive crisis. Which of the following interventions should the
nurse prioritize?
A. Restrict oral fluid intake to prevent fluid overload.
B. Apply cold compresses to painful joints.
C. Administer meperidine for pain management.
D. Maintain adequate hydration with IV fluids.
CORRECT ANSWER: D. Maintain adequate hydration with IV fluids.
Rationale:Hydration is crucial in a vaso-occlusive crisis to decrease blood viscosity and
improve perfusion. Fluid restriction is contraindicated. Warm compresses, not cold, are
used to vasodilate and reduce pain. Meperidine is avoided due to the risk of seizures;
morphine or other non-opioid analgesics are preferred.
Question 3: A nurse is assessing a toddler with suspected lead poisoning.
Which of the following findings is a late manifestation of lead toxicity?
A. Irritability
B. Anorexia
C. Encephalopathy
D. Intermittent vomiting
CORRECT ANSWER: C. Encephalopathy
,Rationale:Encephalopathy (seizures, coma, cerebral edema) is a severe, late
manifestation of lead poisoning. Irritability, anorexia, and intermittent vomiting are early
or mild signs of lead toxicity.
Question 4: A nurse is providing education to a parent of a child with a new
diagnosis of type 1 diabetes mellitus. The parent asks about symptoms of
hypoglycemia. Which of the following is an early sign the nurse should
include?
A. Fruity breath odor
B. Kussmaul respirations
C. Shakiness and pallor
D. Polyuria and polydipsia
CORRECT ANSWER: C. Shakiness and pallor
Rationale:Shakiness, pallor, diaphoresis, and tachycardia are early signs of
hypoglycemia due to the release of epinephrine. Fruity breath, Kussmaul respirations,
polyuria, and polydipsia are signs of hyperglycemia and diabetic ketoacidosis.
Question 5: A nurse is preparing to administer a measles, mumps, and rubella
(MMR) vaccine to a 12-month-old. Which of the following is a contraindication
for receiving this vaccine?
A. A history of a mild local reaction to a previous diphtheria-tetanus-pertussis (DTaP)
vaccine.
B. A temperature of 37.5°C (99.5°F).
C. A current upper respiratory infection with a runny nose.
D. A severe allergy to neomycin.
CORRECT ANSWER: D. A severe allergy to neomycin.
Rationale:The MMR vaccine contains neomycin and gelatin. A severe allergy to
neomycin is a true contraindication. Mild illness without fever, mild local reactions to
other vaccines, and afebrile URI are not contraindications.
Question 6: A nurse is caring for a 4-year-old child who is postoperative
following a tonsillectomy. The child's parent asks for a drink of water. Which
of the following responses should the nurse give?
A. "It is fine to give your child a small sip of water."
B. "I will give your child some orange juice instead."
C. "Let me give your child some ice chips to chew."
D. "Your child should not have anything to drink yet."
CORRECT ANSWER: A. "It is fine to give your child a small sip of water."
Rationale:After a tonsillectomy, clear, cool liquids (e.g., water, apple juice) are
encouraged early to keep the throat moist and promote healing, provided the child is
,fully awake and has a gag reflex. Red liquids (like orange juice) should be avoided to
prevent masking of bleeding. Chewing ice chips can cause trauma to the surgical site.
Question 7: A nurse is assessing an 8-year-old child with cystic fibrosis. Which
of the following findings is most indicative of a pulmonary exacerbation?
A. Increased appetite
B. Decreased respiratory rate
C. Thick, tenacious sputum production
D. Weight gain
CORRECT ANSWER: C. Thick, tenacious sputum production
Rationale:Increased sputum production, particularly thick and tenacious mucus,
indicates a pulmonary exacerbation in cystic fibrosis. Appetite usually decreases,
respiratory rate increases, and weight loss is common during exacerbations due to
increased metabolic demands.
Question 8: A nurse is teaching a parent about the administration of ferrous
sulfate drops for an infant with iron-deficiency anemia. Which instruction
should the nurse include?
A. Administer the drops with milk to improve absorption.
B. Administer the drops with a dropper directly to the back of the throat.
C. Administer the drops with orange juice to enhance absorption.
D. Administer the drops with an antacid to prevent stomach upset.
CORRECT ANSWER: C. Administer the drops with orange juice to enhance
absorption.
Rationale:Vitamin C (found in orange juice) enhances the absorption of iron. Iron
should not be given with milk or antacids as they decrease absorption. Droppers should
be placed at the side of the mouth, not the back of the throat, to prevent aspiration.
Question 9: A nurse is caring for a child who has just had a seizure. Which of
the following actions should the nurse take first?
A. Place the child in a supine position.
B. Administer oxygen via nasal cannula.
C. Check the child's blood glucose level.
D. Assess the child's airway patency.
CORRECT ANSWER: D. Assess the child's airway patency.
Rationale:The immediate priority after a seizure is to assess and maintain airway
patency. The child should be placed in a side-lying position, not supine, to prevent
aspiration. Oxygen and glucose checks are important but secondary to airway
management.
, Question 10: A nurse is assessing a newborn's gestational age using the Ballard
score. Which of the following physical characteristics indicates a mature
newborn?
A. Smooth, shiny, and transparent skin.
B. Absence of sole creases.
C. Pinna of the ear that is soft and flat.
D. Nipples with distinct areola and breast tissue.
CORRECT ANSWER: D. Nipples with distinct areola and breast tissue.
Rationale:Distinct areola and breast tissue are signs of physical maturity in a full-term
newborn. Smooth, shiny skin and absent sole creases indicate prematurity. A soft, flat
pinna is also a sign of prematurity.
Question 11: A nurse is planning to administer the rotavirus vaccine to a 2-
month-old infant. Which of the following is a contraindication for this vaccine?
A. History of intussusception.
B. Mild diarrhea.
C. Exposure to a sibling with roseola.
D. Current antibiotic therapy.
CORRECT ANSWER: A. History of intussusception.
Rationale:Rotavirus vaccine is contraindicated in infants with a history of
intussusception, as there is a small increased risk of recurrence. Mild illness, antibiotic
use, and exposure to roseola are not contraindications.
Question 12: A nurse is assessing a 10-year-old child with acute
glomerulonephritis. Which of the following findings should the nurse expect?
A. Jaundice
B. Periorbital edema
C. Polyuria
D. Hypotension
CORRECT ANSWER: B. Periorbital edema
Rationale:Periorbital edema is a hallmark sign of acute glomerulonephritis due to fluid
retention. Jaundice is associated with liver issues. Oliguria (decreased urine output) and
hypertension are common; polyuria and hypotension are not typical findings.
Question 13: A nurse is caring for a child with a new diagnosis of celiac
disease. The parent asks the nurse which grains are safe for the child to eat.
Which of the following is an appropriate response?
A. Wheat
B. Rye
C. Barley
D. Rice
